住院恶性肿瘤患者合并肺栓塞预测指标的相关研究

Correlative research on predictive indexes of inpatients with malignant tumors complicated with pulmonary embolism

目的:通过选择临床上可常规进行检测的指标或组合相关指标形成的评分或风险模型,探讨对住院恶性肿瘤合并肺血栓栓塞(PTE)患者的预测相对理想的临床指标或评分。方法:本研究通过回顾性研究,随机抽取2018年5月至2019年5月在新疆维吾尔自治区人民医院住院的107例完善肺动脉CT血管造影(CTPA)检查明确诊断为PTE及明确排除PTE的恶性肿瘤患者,分为单纯恶性肿瘤及恶性肿瘤合并PTE组,记录2组患者临床上可常规进行检测的指标及组合相关指标形成的评分或风险模型评分值,筛选出与恶性肿瘤合并PTE相关指标,绘制ROC曲线。结果:肿瘤合并PTE组的Khorana评分、Caprini评分、Wells评分、D-dimer、CRP、心电图异常率较单纯恶性肿瘤组高,而PO_(2)、HDL-C较单纯恶性肿瘤组降低(P<0.05)。logistic回归分析提示Caprini评分、D-dimer值、心电图异常是恶性肿瘤发生PTE的影响因素。ROC曲线分析提示D-dimer值在恶性肿瘤合并PTE的预测价值最好,Caprini评分预测价值也处于较高水平,而心电图异常的预测价值在这三项指标中处于较低水平。结论:针对明确诊断恶性肿瘤的住院患者,D-dmimer值及Caprini评分、心电图异常指标对于恶性肿瘤合并PTE的住院患者预测效果较好,其中ROC曲线分析提示D-dimer值在恶性肿瘤合并PTE的预测价值最好。

Objective Clinically by selecting routinely detectable indicators or combining scores or risk models with related indicators to explore the relatively ideal clinical indicators or scores for the prediction of hospitalized malignant tumor patients with pulmonary thromboembolism(PTE).Methods This study used a retrospective study to randomly select 107 patients who were hospitalized in the People′s Hospital of Xinjiang Uygur Autonomous Region from May 2018 to May 2019 with a complete CT angiography(CTPA)examination of the pulmonary arteries that clearly diagnosed PTE and clearly excluded patients with malignant tumors of PTE.Divided into simple malignant tumor and malignant tumor combined with PTE group,record the clinically detectable indicators of the 2 groups of patients and the score or risk model score formed by the combination of related indicators,screen out the related indicators of malignant tumor combined with PTE,and draw the ROC curve.Results The abnormal rates of Khorana score,Caprini score,Wells score,D-dimer,CRP,and ECG in the tumor combined with PTE group were higher than those in the simple malignant tumor group,while PO_(2) and HDL were lower than those in the simple malignant tumor group(P<0.05).Logistic regression analysis indicated that Caprini score,D-dimer value and abnormal electrocardiogram were the influencing factors of PTE in malignant tumors.ROC curve analysis indicates that the D-dimer value had the best predictive value in malignant tumors with PTE,the predictive value of Caprini score was also at a higher level,and the predictive value of abnormal ECG was at a lower level among the three indicators.Conclusions For inpatients with a clear diagnosis of malignant tumors,D-dimer values,Caprini scores,and abnormal ECG indicators have good predictive effects for inpatients with malignant tumors and PTE.ROC curve analysis indicates the predictive value of D-dimer values in malignant tumors with PTE the best.